Lower Limb Amputation Rates Have Dropped

Despite an increase in diabetes cases nationwide, fewer people with diabetes are facing lower leg and foot amputations than a decade ago, according to the results of a new study.

Because diabetes leads to circulation problems and nerve damage, those who develop the disease are at a higher risk of amputation, especially when faced with slow-to-heal diabetic foot ulcers. Research has suggested that at many as 25 percent of people with diabetes will face amputation.

But according to the study, those numbers are dropping. Led by researchers at the University of Iowa, the study was based on Medicare Part B claims from 2000 to 2010, which showed that the rate of lower extremity amputations dropped 28.8 percent, even as the number of orthopedic treatment claims for diabetic foot ulcers increased 143.3 percent.

In many cases, researchers said, lower extremity amputations have been replaced by partial toe amputations, allowing for better outcomes.

“Amputations at the upper and lower leg level are down 47 percent, while amputations at the partial toe level increased by 24 percent. What this means for patients is increased mobility, independence and survival rates,” said senior author Dr. Phinit Phisitkul.

Researchers said that although additional studies are needed to determine the exact causes of the decrease, they said improved preventive care, insulin control, and orthopedic treatment of diabetic foot ulcers are most likely the biggest contributors to the decline.

According to Dr. Bill Releford, founder of the Releford Foot & Ankle Institute in Beverly Hills, as many as 75 percent of all amputations are preventable. He offered the following tips in a recent press release:

* Do not smoke.

* Exercise daily

* Control your cholesterol.

* Dry in between all toes after bathing.

* Always control your diabetes and blood pressure.

* Always wear shoes made from natural sources such as calfskin or soft leathers.

* Never pull or pick skin from your feet.

* Eat at least five colors of fruits and vegetables every day.

* Never cut toenails or trim calluses if you have diabetes or poor circulation. See a podiatrist for routine foot care.

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Greetings from Nadia

A few facts about me in case you are new to my column and site.

My life in the diabetes community started at a young age as the secret keeper of my maternal and paternal Grandmothers. They both had type 2 diabetes and my days spent alone with them exposed me to their misunderstanding of how their diabetes really affected them. Eating candy bars, hiding the candy wrappers and smoking cigarettes seemed innocent enough to them. A decade later I married a type 1 person living with diabetes and experienced the full court of the diabetes spectrum with my type 2 family members and type 1 husband of almost 20 years.

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My grandmothers, the type 2 have struggled with their diabetes as long as I could remember. Later my mother followed in her mother’s footsteps. Sadly, my brother followed in my mother’s footsteps and experienced an early passing at the age of 53. My brother Jamal’s passing had the greatest impact on me. Probably because were the Irish twins; eleven months apart and his departure devastated me.

As I tell most people, diabetes is not a glamorous profession. Most people that work in the industry have a personal connection. This is why I am still here publishing after 26 years.

On the flip side of the coin, helping and inspiring people is my mission. I understand the daily challenges you face regardless of your education, IQ and economic circumstance. I am not a healthcare professional. Simply a lay person who has lived with a Type 1 and Type 2 family member who struggled with their disease. My former Type 1 husband was a role model in how to manage your diabetes, while my intelligent family members were role models on how an invisible disease can be misunderstood, devastating the quality of their life while leaving heart broken family members behind.

The perils of my experience have taught me to never judge anyone. As knowledgeable as I am, I also realize that I have no idea of the strings that pull at each person heart.

What I love about the diabetes community?

Once I meet someone and we share that we have a common experience; their diabetes and my life long experience as a care taker, we tend to have an instant bond. Think about it. How many people do you meet who you feel really get you right after your introduction? The conversations that follow tend to be very personal. Not a common experience with all strangers.

AskNadia Column

I started this column because where ever I go, people tend to ask me a lot of diabetes questions.

My answers are my opinions and it is not to be replaced by your healthcare professional’s opinion. The answers to your question in most cases will include research and other links to give you a borader perspective on your question.